Functional and surgical outcomes after penile surgery for cancer: Comparison between conservative and non-conservative surgery.

INTRODUCTION

Penile tumours are rare but their incidence is increasing. Their treatment, especially surgical treatment, can be mutilating. There is growing interest in conservative surgery, with the aim of ensuring the best oncological results. This study compares the surgical and functional results of conservative surgery (CS) and non-conservative surgery (NCS).

METHODS

This is a single-centre retrospective study conducted between 2010 and 2022 in patients who underwent surgery for invasive squamous cell carcinoma. Clinical, surgical and histological data, complications, and urinary and sexual functional outcomes were collected.

RESULTS

Fifty-seven patients were included: 32 underwent conservative surgery and 25 non-conservative surgery. The median follow-up period was 34 months [14; 54], and the median age was 66.8 years [56.8; 74.2]. Lymph node assessment was performed in 32 patients (56.2%). Complications occurred in 22 patients (39%), mainly related to lymph node procedures and more frequently in NCS. Seven patients (15%) had disabling urinary symptoms at one year, with no difference between groups. Urethral stricture occurred in 9 cases (15.8%). The median IIEF-15 score was 21 postoperatively compared with 57 before the disease. It was better in CS at 49 compared with 10 (P=0.019).

CONCLUSION

Surgical treatment of penile cancer varies greatly, with significant perioperative morbidity. The majority of patients regain urinary comfort with few repeat operations. Many patients retain sexual activity, which is less affected by conservative surgery.

LEVEL OF EVIDENCE: 3 : Retrospective Cohort Studies.